HomeMy WebLinkAbout2970 ~ . . . . ~
Deciarat~on of Domicile and Citizenship
4~Q439
TO THE CLERK OF THE CIRCUIT COURT.
ST. L UC I E COUNTY. FLORIDA:
This is my deelantion of Domica7e and Citi::aaship in the State of Florida that I am filing this day in acoordanoe. and in
conformity with Section 222.17. F`brida Statutes.
I wan formed a legal resident of l ~ - and I
~1 yl 18uta)
resided at ~ ~ . However. I have changed my domicile to
(8tnat and Number)
and am and have been a bona fide resident of the State of Florida aiaoe a ~ t~ ~ day of
Q.} / 7 s
(L/i ~ .19 and I reside at / u
(8teeat and Number)
~-l e~ f ~ - i ~ _ ST . LUC I E County. Florida.
ccxcyl
and this statement is to be taken as my declaration of citizenship. actual legal residence and domic~7e in the State of Fbrida.
_ IF iOR THE PURPOSE OF ENROLLING IF fOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
THEIR NANES: A
- ~'7
/l')'L-1?-cl>;d ~/~,tiL-L~ CI-titC! C,~-G1',~ ~~LL~
nn
.L~ Cc. ~ 1(Ll G~, CE ~F Q~l. ~~~~Yl-t - ' .Q~L~rr~ ~ ~Cd
i
I FURTHER CERTIFY that I w~11 register at my local address when the registration books reopen, and comply with all
i other requirements of a legal resident of this State.
s
t
I FURTHER CERTIFY that I have no intention to return to my former domitik. and I intend to remain in
J T. L U ~ 1 E County.
` ICtityl
s Fbrida. permanenti;. ~R 2 ~ ~ ZS
_ _ F1L~~E~~0 ANC PECrORQEQ
~ S IIOSER
POITRAS A.
CLERK CIRCWT COtQtT~
RCCORO YERIFiFO_ T~ _
\ is e•.ea,'••., . C
~ ~31D~43y
J ~ O
V:
V~
~ ~ i~ P
k .
~
~ ~ s
. ~ IAddr~
Sworn to and subsrn'bed before me this ~ ~ day of - ~ .1 ~ u c - -~lc - 3 c ~ Z
_ ` Q
~ (!~-CAL-- A.D.19~...
5
R P'01 AS CLERK F G IRCUI T COtdFtT
ST. LUGIE COUNTY, FLORIDA
-
e EPUTY LERK
~~327
~ ern Farm 71 22